What Is It?

Eczema is a general term describing skin inflammation, also known as dermatitis. There are many different forms of eczema, the most common being atopic eczema (atopic dermatitis). Contact eczema (contact dermatitis) and seborrheic eczema (seborrheic dermatitis) are two other forms that occur commonly and will be discussed here.

Atopic eczema is a chronic skin disease that causes itchy inflamed skin, and is thought to be the result of an abnormal immune response. In about two-thirds of those who develop atopic dermatitis, it begins during infancy. It is often associated with the other allergic (atopic) diseases – hay fever (allergic rhinitis or nasal allergies) and asthma. In infants, atopic eczema is also known as infantile eczema.

Contact eczema develops in direct response to an irritant or allergen that has come in contact with the skin. Due to the many possibly irritants and allergens, it may be difficult to determine what is causing the reaction.

Seborrheic eczema is a form of skin inflammation that involves oily, scaly patches of skin that commonly occur on the scalp and face. Dandruff and cradle cap (in infants) are the most common conditions caused by this type of eczema. In contrast to most types of eczema, this type does not necessarily itch.

What Causes It?

The causes of eczema are not always known, but the following factors play a role in its development or progression: (read more)

• Immune dysfunction

• Dry, irritated skin

• Irritant exposure

• Allergen exposure

• Antibiotic overuse

• Dysbiosis

• Leaky gut

• Food allergy

• Gluten sensitivity

• H. pylori infection

• Yeast overgrowth

• Candida overgrowth

• Genetics

At the basis of atopic eczema is a combination of immune dysfunction and a disturbance of the outer layer of skin. The outer layer, called the epidermal barrier (because it functions as a protective layer), weakens. This epidermal barrier weakening causes thinning of the skin and a loss of moisture, producing the characteristic dry skin that is seen in eczema. The immune dysfunction results in an excessive inflammation of the skin—the hallmark redness, swelling and pain of eczema.

Eczema may be triggered by an irritant that comes in contact with the skin, that is inhaled, or that is consumed. These irritants may also be considered allergens if the skin reacts by producing allergic compounds. In some people, allergic reactions take years to develop, so that only after repeated exposure to an allergen will a reaction occur that produces eczema symptoms.

Irritants or allergens that may cause an eczema reaction include:

• Soap

• Cosmetics

• Deodorants

• Fragrances

• Lotions

• Medications

• Cleaning products

• Insecticides

• House dust

• Pollen

• Molds

• Pet dander

• Rubber or latex

• Metals

• Costume jewelry

• Perfume

• Hair dye

• Plants like poison ivy

• Foods

The use of neutral, or slightly acidic soaps (as opposed to alkaline soaps which are most common) may help people with eczema. The natural pH of the skin ranges between 4.5 and 6.5. This is slightly acidic, which helps to repel bacterial growth. When alkaline soaps are used, this changes the pH of the skin and can create a more hospitable environment for pathogenic bacteria. Soaps and shampoos that are at a slightly acidic pH are recommended.

The overuse and repeated use of antibiotics, especially in infants and children, can interfere with the healthy population of beneficial bacteria in the gut that is so essential in developing proper immune response. Indeed, early use of antibiotics in children and even antibiotic use by the mother during pregnancy, has been associated with the development of eczema in children.

Dysbiosis, an imbalance in the ratio of good to bad bacteria in the gut, has been associated with the development of eczema. Dysbiosis is thought to negatively affect the proper development of immunity in infants. Dysbiosis may occur for a number of reasons. Antibiotic use, infection, lack or inadequacy of breastfeeding, Candida overgrowth, parasites and poor diet can all lead to dysbiosis.

Dysbiosis creates an unfavorable environment in the gut that promotes the development of leaky gut, or increased intestinal permeability, through which larger than normal particles can pass through into the bloodstream. These particles include undigested food, environmental toxins and microbial toxins (this includes bacterial, viral, fungal and parasitic). When these enter the blood stream, the immune system responds by creating inflammatory compounds that travel throughout the body. In people with eczema, this inflammation is experienced in the skin. Indeed, leaky gut is found in children with atopic eczema involving an immune system response to larger particles that pass through the intestine.

Food allergy is one result of the passage of undigested food particles through the leaky gut. The food remains undigested when there is an insufficient amount of stomach acid, digestive enzymes, or both. High amounts of food allergy antibodies are found in people with eczema. Antibodies are what the immune system produces in response to an allergen. Many people have found relief from eczema by following an elimination diet.

Gluten sensitivity is one particular food allergy that is seen in people with eczema. Patients with celiac disease, the most severe form of gluten sensitivity, were found to have atopic eczema three times more frequently than those without celiac disease. The best way to determine if a person has a gluten sensitivity is to follow a gluten-free diet for at least four weeks to see if allergic symptoms decrease.

With seborrheic eczema, like dandruff or cradle cap (in infants), an overgrowth of the yeast Malassezia is common. This yeast is normally present on humans in oily areas of the skin. In seborrheic eczema, this yeast is found in higher concentrations. It feeds on the fatty oils found in these areas of the skin and proliferates creating the flaking and oily scales that are characteristic of this type of eczema.

Candida overgrowth is also found in people with eczema, especially severe eczema. Candida is a yeast that is present in and on the bodies of many people. Normally it exists in a small concentration, kept in balance by other bacteria. But when Candida growth increases, it can create many problems, and may be involved in the development or worsening of eczema in some people. An underlying Candida overgrowth can interfere with the healing of eczema and should be ruled out.

Atopic eczema often occurs in families in which the other allergic diseases (hay fever and asthma) occur. Additionally, it is common for a person with eczema to also have another allergic disease. There is a 35 percent chance that an individual with eczema will also have hay fever, and a 30 percent chance of having asthma.

Factors that may worsen eczema include:

• Long baths or showers

• Stress

• Sweating

• Cigarette smoke

• Wool or synthetic fabrics

• Chemical irritants

• Allergens

• Certain foods

What Are the Signs and Symptoms?

Atopic eczema is an itchy inflammation of the skin. It can affect any part of the skin, but most commonly appears in large skin folds like the inner elbow crease and behind the knees. (read more)

Symptoms of atopic eczema include:

• Discolored skin patches

• Severe itching, especially at night

• Small raised bumps which may drain fluid and/or crust

• Thick, cracked or scaly skin

• Raw, sensitive skin

Contact eczema appears on any area of the skin that has come into contact with an irritant or allergen.

Symptoms of contact eczema include:

• Rash or bumps

• Itching

• Dry red patches

• Blisters or draining fluid

• Rash limited to exposed area

• Pain or tenderness

Seborrheic eczema mainly affects the scalp, but may also affect other oily areas of the body such as the face.

Symptoms of seborrheic eczema include:

• Scales or thick crusts on the scalp that may attach to the hair shaft

• Red oily skin covered with flakes or scales

• Itching or soreness

• Flakes or dandruff

Brenda’s Better Way

Like all skin conditions, the gut-skin connection can be seen. Anytime there is an intestinal imbalance of the microbial flora (consisting mostly of bacteria and fungi), a dysregulated immune response often occurs leading to systemic effects which can include many areas of the body, and certainly includes the skin. Eczema (also known as atopic dermatitis) can be seen in association with other atopic conditions, such as hay fever, asthma or hives, but is generally not triggered by pollen or other airborne irritants.

The frequent use of antibiotics, the promotion of a germ-free environment, too many vaccines, and a high-sugar diet, which promotes Candida overgrowth and dysbiosis are all factors that stimulate the cellular immune response causing eczema.

What’s more, there are data to support the fact that children in mostly Western industrialized countries are “too clean.” These children generally do not play in the dirt, may not be exposed to pets, are often not breastfed, and receive about 40 vaccinations before attending school at age 5. The vaccines begin right at birth, with the hepatits B vaccine, at a time when the immune system is still underdeveloped. (Because of serious immune issues, France has stopped this practice of giving hepatitis B immunization at birth.) It’s interesting to note that children raised in a less-than-sterile environment actually develop more balanced immune systems.

If your skin, which is the outer protective coating of your body, has eczema, then your intestinal lining, which is the inner protective coating of your body, is also inflamed in a similar way. When the digestive tract is out of balance, it sends an increased amount of toxins to the liver. The liver can become overburdened, dumping toxins that it is unable to process back into the body. The other organs of elimination must then eliminate these toxins. The skin is one major secondary route of this elimination.

Addressing gut imbalance should be the first step for people with eczema. Because Candida overgrowth and gluten sensitivity are common in people with eczema, following the Skinny Gut Diet while avoiding gluten is a good idea. A minimum of three months is needed to allow the diet the time it needs to heal the body from the inside out.

Replacing the beneficial gut bacteria with probiotics is an important part of managing this condition. Follow the recommendations below and on the next page for a whole-body approach to treating eczema.

Rule Out

• Candida overgrowth

• Gluten sensitivity

• H. pylori infection

Recommended Testing

• Comprehensive stool analysis (CSA)

• Gluten sensitivity test

Diet

• If Candida overgrowth or gluten sensitivity are issues, follow the Get Lean Phase of the Skinny Gut Diet Eating Plan until the skin clears up. Then follow the Stay Lean Phase for maintaining skin health.

• If none of these are an issue, still follow the Stay Lean Phase of the Skinny Gut Diet Eating Plan, which will help to minimize gut irritants and promote a healthy internal environment.

Lifestyle

• Taking fewer showers and baths, or limiting time spent bathing can be helpful for those with eczema.

• Avoid cosmetics that contain harsh ingredients that may irritate the skin.

Complementary Mind/Body Therapies

• Colon hydrotherapy is helpful to aid detoxification.

• Stress can be a major component of this disease, so find ways to reduce it with therapies such as meditation, yoga, deep breathing, massage, biofeedback, or music therapy.